Abstract
BackgroundThe International Committee of the Red Cross (ICRC) has developed its ‘Accompaniment model’ to address the multi-faceted needs of relatives of people who go missing during armed conflict. In Sri Lanka an Accompaniment Programme was launched in 2015 for the relatives of the more than 16,000 missing persons who remain unaccounted for.MethodOne thousand seven hundred eighty-three relatives who took part in the mental health and psychosocial support (MHPSS) component of the ICRC’s Accompaniment Programme in Sri Lanka between April 2016 and August 2017 were offered eight peer-support group sessions, individual home visits, referrals to local services, and commemoration events to pay tribute to their missing relatives. Symptoms of anxiety and depression (using the HADS scale), somatic difficulties (using the BSI scale) and daily functioning (ICRC scale) were assessed before and after the MHPSS intervention.ResultsPrior to receiving support, Tamil and Muslim ethnicity, ≥60 years of age and civilian status were predictors of severe symptoms of anxiety; Tamil ethnicity, ≥50 years of age and being the mother of a missing person were predictors of severe symptoms of depression; and ≥ 50 years of age and severe symptoms of anxiety and depression were predictors of severe somatic difficulties. After receiving support, the vast majority of the relatives of missing persons showed reduced levels of anxiety (81%), depression (79%) and somatic pain (77%), as well as increased functioning (75%). Predictors of improvement following support were severe levels of distress at baseline and Tamil and Muslim ethnicity. In addition, attending at least three group sessions was a predictor of decreased anxiety, age group 51–60 was a predictor of decreased depression, female gender was a predictor of decreased somatic difficulties, and referrals were a predictor of increased functioning.ConclusionThe MHPSS component of the ICRC’s Accompaniment Programme is a relevant approach to helping families to cope with not knowing the fate and whereabouts of their missing relatives, to reduce distress, to break their social isolation and to resume more functional lives. However, further research is needed, possibly through a controlled trial, to better establish the effectiveness of this approach.
Highlights
The International Committee of the Red Cross (ICRC) has developed its ‘Accompaniment model’ to address the multi-faceted needs of relatives of people who go missing during armed conflict
The discrepancy was primarily due to difficulties in merging data between databases, as any discrepancy in names due to spelling differences led to mismatches
The relatives most likely to present severe symptoms of anxiety prior to receiving an mental health and psychosocial support (MHPSS) intervention were relatives from the Tamil and Muslim ethnic groups (OR = 2.33 and odds ratios (OR) = 2.45, respectively), relatives above 60 years of age (OR = 1.85) and relatives of civilian missing persons, who had 64% higher odds of suffering from severe anxiety compared to relatives of soldiers missing in action
Summary
The International Committee of the Red Cross (ICRC) has developed its ‘Accompaniment model’ to address the multi-faceted needs of relatives of people who go missing during armed conflict. The International Committee of the Red Cross (ICRC) seeks to address the multi-faceted needs of relatives of missing persons through the Accompaniment model [1]. The main goal of accompaniment is to strengthen the ability of individuals and families to deal with difficulties related to the disappearance of their relatives and to resume their social lives. They can do this by making use of their own resources and those available in the community – local and national – and by creating a supportive network
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